fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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El Jugo Me Hizo Daño

February 2010:

I toss and turn in bed, trying to fall back asleep; I have only a small cushion of time between getting up and heading to the hospital. I’m a third-year medical student doing my medicine subinternship. I have the choice of going to work or staying in bed a little longer.

On the other side of town, Ms. Garcia doesn’t have much choice about heading to the hospital: She’s bleeding from her nose and rectum. Standing in a puddle of blood, she calls 911.

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Gunshot

Detroit, January 1997

In a haze of sleeplessness, I open the door to the general-surgery call room (aka “the Garage”) just after midnight. I’m one of two third-year medical students on this call team, and if I arrive first, I might be able to avoid the bunks with the most creased sheets and the pillows with head indentations still on them. The entire general-surgery team sleeps in this one room, with its messy bunks for eight and its odor of stale bodies. That is, we sleep during free moments, in rare fits, interrupted by pagers beeping and the door opening with a flash of light and closing with a loud click.

Climbing to an upper bunk, I get beeped: Code 1.

“Fuck, another gunshot victim,”

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Miracle Worker

“There’s a transplant happening today,” said Sophie Lee, a resident, glancing at her pager.

It was a Saturday afternoon, and I was a second-year medical student doing a clerkship on the hepatobiliary surgery service (specializing in the liver and bile ducts).

I felt a pang of disappointment: Now I couldn’t go home until after dinner. But there was no use complaining. I followed Sophie to see the transplant recipient, Mr. Franklin.

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Finding a Common Chord

“I long, as does every human being, to be at home wherever I find myself.” — Maya Angelou

Before starting my dive into medicine, almost four years ago, I was an avid violinist, pianist, disc golfer and novice chef. Each of these activities felt comfortable and familiar–like “home.” But when I began medical school, I somewhat wistfully set them aside to focus on becoming a doctor.

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Troubleshooter

As a third-year medical student midway through a family-medicine rotation, I’m supervised by a family physician in several free clinics in our large city.

On Fridays, we run a clinic for torture victims who’ve left their home countries to seek asylum in the US. I’ve been following a new patient, Julian, an African refugee.

Julian is a small, thin man in his early thirties. His large eyes, shy smile and soft voice belie the determination and resilience evident in his story.

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Extracurriculars

Extracurriculars

If harsh words fall, but no patient is around to hear them, do they make a sound?

This particular night on my trauma-surgery rotation as a fourth-year medical student, the question weighs heavily as a page alerts the team that a patient with multiple gunshot wounds will arrive in ten minutes.

Everyone’s kind of excited. Anxious, too. Jittery.

1:00 am. Down in the ED, the main actors stand masked, gowned and ready to go. ED Cowboy stands at the head of the bed, Surgery Senior stands to the side. Alongside them, the throngs of people without obvious purpose who always seem to show up just in time for the evening’s episode of “drama in the trauma bay.” Everyone’s done this a thousand times before. Well,

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Code Pink

Code Pink

When a code is called in the hospital, it means two things: A caregiver’s day is about to be turned upside-down, and a patient’s world is about to fall to pieces. If you’re a caregiver, when a code is called you look up from your own work and wonder who’ll be sprinting through the halls and whose story is unfolding.

This time, the story was ours.

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Mommy Chuy

Mommy Chuy

Mrs. Hernandez is a ninety-two-year-old Spanish-speaking woman, originally from Mexico, with high blood pressure and high cholesterol, who arrived in the emergency department of the hospital where I’m a fourth-year medical student.

Her right arm and leg were weak, the right side of her face drooped; her speech was slurred, and she seemed confused. Her CT scans showed that a blood clot had blocked her middle cerebral artery, in the area of the brain that governs language. Mrs. Hernandez was a stroke victim.

Mrs. Hernandez is also my abuela.
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An Ounce of Empathy

An Ounce of Empathy

I am a medical student in my third year of studies. For medical students, this is the point at which, after two years of book learning, we rotate through hospital clerkships that give us our first experience of delivering hands-on care to inpatients.

Earlier in the year (it feels like many lifetimes ago), I read that COVID-19 was “just the flu.” We heard from scientific sources and popular media that other maladies were much worse, and that it would be a mistake to overreact to this one. Like many people, I accepted these assurances without too much concern. It all seemed a bit remote to me–the way I imagine issues like food stamps may seem to a politician who’s never needed them.

But now

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Vision Quest

After finishing my third-year clinical rotations in medical school, I was feeling sleep-deprived and stressed out. The problem, I finally realized, was the ridiculous amount of pressure I’d put on myself to impress my attending physicians and get good grades.

My father is an ophthalmologist and cornea/cataract specialist. After routinely rejecting his career advice throughout my undergraduate years, I’d entered medical school–and, to my father’s delight, found myself increasingly fascinated by his field.

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Sounding the Alarm

Sounding the Alarm

For most medical students, the fourth year is a time of coming into our own. We’ve completed our clinical clerkships, passed our first board exam and begun applying to residencies in our hoped-for specialties.
We also get our first taste of independence as clinicians.
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Breadwinner

Breadwinner

The first thing I notice are the dark circles under Mr. Jones’s eyes.

It’s 4:30 pm on a Wednesday during my third year of medical school. I’m in the fifth week of my family-medicine rotation, and we’re deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.

Mr. Jones is a new patient. His face and belly are round, his arms and legs lanky. His unkempt facial hair and calloused hands reflect a life of physical labor that has worn him down. According to his chart, he’s just started an office job. Slumped apathetically in a chair in the corner, he seems apprehensive and hesitant to talk to me. Understandably so: I’m a stranger

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